Anxiety and stress during the Covid-19 lockdown could see many people turn to addictive substances for relief. This jeopardises their own mental health, as well as, the well-being of their loved ones, warns Samukelisiwe Mthembu, clinical psychologist at the Choose Life Specialist Recovery Centre on Durban's Berea.

She points out that this period could prove especially challenging for people struggling with mental health disorders. As each condition comes with its own set of challenges and fragility, people resort to different solutions as a means of self-medicating.

"People with depression often search for an emotional relief abusing alcohol or pills (such as sedatives) in order to escape reality. Boredom and loneliness, brought about by the lock-down, can also lead to an increase in consumption of substances which could heighten present or potential risk of abuse, addiction, or dependence," she says.

Although government has banned the sale of alcohol and tobacco products during lockdown, Mthembu says many have found loopholes that ensure that potentially addictive substances remain readily available.

"The unofficial sale of banned items is growing to fill the gap left by the closing down of retailers. Also, the selling of illegal substance continue as usual, as dealers are even more organised around not adhering to the law. Another threat is the abuse of over the counter or prescription medication as pharmacies remain open during the lockdown," she warns.

The good news is that specialist rehabilitation centres such as the Choose Life Specialist Recovery Centre at 79 Windmill Road, Durban are considered essential services. Thus, their doors remain open to those suffering from addiction and for the added support to their families.

The extra time during lockdown could even provide the perfect opportunity for those seeking rehabilitation to take time out to heal, Mthembu suggests.

She advises those impacted by a family member's addiction to gather as much information as possible in order to help them to find a solution. By learning about a suspected mental health disorder that may be sparking an addiction, family and friends are better equipped to move away from criticizing towards persuading their loved ones to seek the help that they need.

One of the most prevalent problems is anxiety - a disorder that may be exacerbated by the deteriorating Covid-19 situation.

While fear is a healthy emotional response to a real or perceived imminent threat, helping us to respond to danger through fight-or-flight, anxiety is often a maladaptive anticipation of a potential future threat.

"People with anxiety tend to over-analyse situations, over-anticipate problems and persistently and excessively worry which affects their general well-being and quality of life. This anxiety usually becomes pervasive and can become very debilitating. People with anxiety often find their sense of security in both stability (things not changing too often) and certainty (knowing what is coming next). It is easy to see how COVID-19, the sudden changes and the uncertainty of what is going to happen, can aggravate such a person's anxiety levels.

"Being stuck at home with lock-down, they might attempt to regain control through reading everything on the internet. This is worrying in itself but sensation-seeking fake news can create excessive alarm. At the same time, the routines and structure that create the stability on which they depend have been disrupted, leaving them with a lack of familiarity and security," she explains.

Those battling depression have to contend with anxiety and more, she continues.

"In major depression, the most prominent symptom is a severe and persistent low mood, profound sadness or a sense of despair. During the lockdown, a depressed person is confined to home with no more walks on the beach or outings to act as distractions. This person might try to escape reality through excessive sleeping or even substance abuse."

Mthembu notes that, although depressed people sometimes actively avoid others, they have a deep need for connection, understanding, support and encouragement. It is therefore critical for them to be interactive as isolation frequently reignites ingrained patterns of negative thinking.

"It is therefore problematic that somebody who is already struggling to connect with others now finds him or herself isolated, disconnected and lonely due to the lock-down," she says.

An understanding of addiction explains how those with anxiety or depression may take refuge in various substances.

According to Mthembu, the human brain has neuronal pathways that can best be described as a reward system. Feel-good chemicals are released when certain activities provide a sense of accomplishment or fulfilment. Psycho-active substances (such as drugs and alcohol) activate the brain's reward system, producing feelings of pleasure.

Central Nervous System (CNS) suppressants such as alcohol, cannabis and sedatives provide a feeling of relaxation and disinhibition while CNS stimulants such as cocaine and crystal-meth activate the brain, creating a euphoric feeling known as a high.

"Often people struggling with stress, anxiety and worry such as that sparked by the Covid-19 lockdown, abuse CNS suppressants when they feel overwhelmed by the emotions evoked by the uncertainty of their situation. People with depression search for something to kill their emotional pain," Mthembu says.

She appealed to those who were concerned about spiralling levels of substance abuse to seek assistance immediately and not try to wait out the Covid-19 lockdown before finding help.

All leading rehabilitation centres are covered by medical aids.

Choose Life is fully COVID 19 compliant, so clients do not have to worry about contracting the virus.